Objectives: To 1) describe changes in the electrical stapedial reflex threshold (eSRT), within and across patients over time and 2) to identify the clinical relationship between eSRT and an individual's upper limit of loudness. Study Design: Retrospective chart review and analysis using a multilevel modeling approach to describe changes in eSRT over time. Setting: Secondary care center. Patients: Two-hundred five cochlear implant recipients treated at the cochlear implant center during a 3-year time period. Intervention(s): Cochlear implantation, eSRT testing, and, electrical upper limits of loudness. Main Outcome Measure(s): The eSRT over multiple appointments and the cochlear implant recipients' final upper limits of loudness. Results: Analysis of the eSRT testing indicated stability over time; no global trend was seen in trajectory across the population, b = –0.010, p = 0.899. The relationship between eSRT and user upper limits of loudness revealed a mean decrease of 19.47, units for manufacturer 1, 30.53 units for manufacturer 2, and 0.7 units for manufacturer 3. Conclusion: Electrical stapedial reflex thresholds remain consistent for individual subjects over time with implant experience being the only variable correlated with eSRT stability (increase in 5% of one standard deviation with each year of experience). In addition, a clinical relationship between eSRT and behaviorally set upper limits of loudness was identified for all three cochlear implant manufacturers available in the United States.
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